More New Drugs, Yes. Lots More Sales? Not Always, Thanks to Skeptical Payers

More new drugs. More drug sales? Not so much. As The Wall Street Journal reports, pharma companies racked up 271 new drug approvals from 2006 to 2010, but only a baker's dozen of them have broken through the blockbuster barrier.

That's a major comedown from the previous 5 years, when 33 new launches surpassed $1 billion in sales. And don't blame it on the waning of the mass-market blockbuster: One of the most successful drugs in the first half of that decade was the rheumatoid arthritis treatment Humira, now the best-selling drug in the world. During the latter period, Merck's  diabetes treatment Januvia hit the market — and these days, there's no more mass-market ailment than diabetes.

But you can blame the patent cliff, at least partly. As the blockbusters minted in the 1990s fall off patent, they're posing low-cost competition for newly approved brands. Generic versions of Pfizer's Lipitor, which went off patent in late 2011, have limited the recent growth of AstraZeneca's more potent statin, Crestor (rosuvastatin).

You can also blame price-conscious payers, who are less likely these days to back new drug brands that are marginally better than their predecessors. Insurers now slap much higher copays on pricier new meds and often require patients to try cheap generics before moving to the latest brands.

Pfizer CEO Ian Read tells the WSJ that pressure to try generics first is a barrier to new launches: "That does slow up the penetration of new classes," Read told the Journal. Pfizer's own new RA drug, Xeljanz (tofacitinib), a first-in-class treatment, has been a bit slow off the mark, but the company says its promotional efforts with doctors are starting to pay off, the WSJ notes.

For true breakthroughs, however, sales can go stratospheric — and quickly. Consider any of the drugs on FiercePharma's list of drug-launch superstars. Biogen Idec's Tecfidera (dimethyl fumarate), the multiple sclerosis treatment launched in late April, hit $192 million in sales by the end of the second quarter. Albany, NY-based Regeneron and Bayer's Eylea (aflibercept) went zero-to-blockbuster in just over a year in the macular degeneration market. And Foster City, CA's Gilead Sciences rolled out its breakthrough new hepatitis C treatment, Sovaldi (sofosbuvir), less than 10 days ago, and already analysts are predicting almost $2 billion in 2014 sales.